Joseph Douglas Dedeaux

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

6670 Alton Pkwy
Irvine, CA 92618-3734

Phone

(949) 932-5000

NPI assigned

Nov 8, 2018

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• California Luna Care Physical Therapy PC

  • Physical Therapist
  • Los Gatos, CA
  • NPI 1689162166
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Baldwin Park, CA
  • NPI 1770515280
  Medicare reassignment NPD
• Southern California Permanente Medical Group

  • Health Maintenance Organization
  • Los Angeles, CA
  • NPI 1134151657
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1541635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638144000000",
    "number": "1477021442",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3872 URIS CT",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926061729",
            "telephone_number": "949-422-3018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6670 ALTON PKWY",
            "city": "IRVINE",
            "state": "CA",
            "postal_code": "926183734",
            "telephone_number": "949-932-5000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3872 Uris Ct",
            "address_purpose": "LOCATION",
            "city": "Irvine",
            "state": "CA",
            "postal_code": "926061729",
            "country_code": "US",
            "telephone_number": "949-422-3018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DEDEAUX",
        "first_name": "JOSEPH",
        "middle_name": "DOUGLAS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-11-08",
        "last_updated": "2021-11-29",
        "certification_date": "2021-11-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9400 Rosecrans Ave",
            "city": "Bellflower",
            "state": "CA",
            "country_code": "US",
            "postal_code": "907062246",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Hilary Sarah Dearth, M.A., BCBA
• Stacy Debrow
• Kimberly Ahluwalia Dechellis, LMFT
• Derek Mario Decicco, MPT
• Karen Matsumoto Deck, N.P.
• Deepika Dhama, D.D.S.
• Brittany Deering
• Anton J Degeus, DDS
• Lino J Deguzman, M.D.
• Sabrina Herrera Deguzman

• Physical Therapist in Irvine, CA
• Providers in Irvine, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.